Detección incidental de niveles de vitamina B12 elevados y su relación con neoplasias

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
J. Pardo Lledias , M. Martín Millán , J.A. Mazariegos Cano , C. Aibar Marco , N. Arias Martínez , B. San Pedro Careaga , E. Urizar Ursua , M.C. Insua García , B.A. Lavin Gómez , J.L. Hernández Hernández
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引用次数: 0

Abstract

Background and objective

Elevated serum levels of vitamin B12 have been associated with oncohematological diseases. However, the relevance of its incidental detection in subjects without a previous diagnosis of cancer is unknown. The aim of this study was to evaluate the relationship between incidental hypercobalaminemia (vitamin B12 > 1000 pg/mL) and the diagnosis of a tumor process in patients without a diagnosis and to establish the risk factors.

Material and methods

Retrospective observational study of a cohort of patients with hypercobalaminemia. The incidence of neoplasms was compared with a cohort of patients with vitamin B12 levels < 1000 pg/mL.

Results

Vitamin B12 determinations of 4800 subjects were selected. Of them, 345 (7.1%) had levels > 1000 pg/ml; 68 (28.4%) were excluded due to exogenous administration, 12 (5%) due to insufficient data, and 15 (3%) due to having an active neoplasia, selecting 250 patients, with a median follow-up of 22 (IQR: 12-39) months. Structural liver disease was detected in 59 (23.6%). 18.2% (44 patients) had solid organ cancer and 17 (7.1%) had malignant hemopathy. The average time from the detection of hypercobalaminemia to the diagnosis of cancer was about 10 months. The median until the diagnosis of neoplasia was higher in the high vitamin B12 group (13 vs 51 months; P < .001). Hypercobalaminemia (HR: 11.8; 95% CI: 2.8-49.6; P = .001) and smoking (HR: 4.0; 95% CI: 2.15-7.59; P < .001) were independent predictors of neoplasia in the multivariate analysis.

Conclusions

Incidental detection of serum vitamin B12 levels > 1000 pg/ml is high in the population. The diagnosis of solid organ and hematological neoplasia is frequent during the following year of follow-up, with hypercobalaminemia and smoking being predictors of a higher risk of cancer.

意外发现维生素 B12 水平升高及其与恶性肿瘤的关系
背景和目的血清中维生素 B12 水平的升高与肿瘤血液病有关。然而,在既往未确诊癌症的受试者中偶然检测出维生素 B12 与癌症的相关性尚不清楚。本研究的目的是评估未确诊患者偶然出现的高钴胺血症(维生素 B12 1000 pg/mL)与肿瘤诊断之间的关系,并确定风险因素。结果选取了 4800 名维生素 B12 测定对象。其中,345 人(7.1%)的维生素 B12 含量为 1000 pg/ml;68 人(28.4%)因外源性用药而被排除,12 人(5%)因数据不足而被排除,15 人(3%)因患有活动性肿瘤而被排除,共选出 250 名患者,中位随访时间为 22 个月(IQR:12-39 个月)。59例(23.6%)患者发现结构性肝病。18.2%(44 例患者)患有实体器官癌症,17 例(7.1%)患有恶性血病。从发现高钴胺血症到确诊癌症的平均时间约为 10 个月。高维生素 B12 组患者确诊肿瘤前的中位时间更长(13 个月 vs 51 个月;P < .001)。在多变量分析中,高钴胺血症(HR:11.8;95% CI:2.8-49.6;P = .001)和吸烟(HR:4.0;95% CI:2.15-7.59;P <;.001)是肿瘤的独立预测因素。高钴胺血症和吸烟是癌症风险较高的预测因素。
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来源期刊
Revista clinica espanola
Revista clinica espanola 医学-医学:内科
CiteScore
4.40
自引率
6.90%
发文量
73
审稿时长
28 days
期刊介绍: Revista Clínica Española published its first issue in 1940 and is the body of expression of the Spanish Society of Internal Medicine (SEMI). The journal fully endorses the goals of updating knowledge and facilitating the acquisition of key developments in internal medicine applied to clinical practice. Revista Clínica Española is subject to a thorough double blind review of the received articles written in Spanish or English. Nine issues are published each year, including mostly originals, reviews and consensus documents.
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